Pessaries have been used for centuries in the management of pelvic organ prolapse. Although surgical repair has been popularized by surgeons and gynecologists for younger women with pelvic relaxation, pessaries remain a useful palliative strategy for patients who refuse surgery as represent higher operative risks. Methods: Due to the recent advancement of material science, medical-grade silicone has replaced the traditional rubber, plastic, or Lucite, since it is more durable and non-allergenic. The authors used silicone ring pessaries in 98 Korean women with pelvic organ prolapse compromising those who are at high risks for anesthesia because of medical disease, who want to conceive in the further or those who wish to avoid surgical therapy. Results: 1. The average age of patients is 62.69±11.37 years. Period of pelvic organ prolapse is 78.64±56.23 months and duration of pessary insertion is 17.34±11.75 months. 2. The average time point of first complication was 7.91±4.25 months. The time point of complication of user group and non-user group of estrogen and lubricant was 10.06±3.31 months and 4.13±3.27 months, respecitively, which shows that complication occurred later in user group than in non-user group. 3. Pessary with support(16 out of 43 patients, 37.2 %) shows more serious complications (ulceration of vaginal wall) than pessary without support(1 out of 37 patients, 2.7 %). 4. The pessary sizes that fit best the prolapsed uteri of Korean women are #3(diameter of 63.5 mm) and #4(diameter of 69.8 mm) (60 out of 77, 77.9 %). Natural correction rate after removal of pessary(pessary insertion period: over 1 year) was 22.7 %(10 out of 44). 5. The most common complication in patient with uterine prolapse with or without cystocele is erosion. On the other hand ulceration of vaginal wall is the most common complication in those with rectocele and cystocele. 6. Among patients with pelvic organ prolapse in Korea, when there was uterine prolapse only, #3 and #4 pessary without support was the most commonly used(22 of 35, 62.9 %). When uterine prolapse was accompanied with rectocele or cystocele, #3 and #4 pessary with support fitted the best (accompanied with cystocele only: 14 of 26, 53.8 %, accompanied with cystocele and rectocele: 8 fo 9, 88.9 %). Conclusion: The above results suggest that we could recommend more utilization of proper shaped and sized pessary of patients with pelvic organ prolapse along with regular follow-up examination and proper use of estrogen, Trimosan, antibiotics, and anti-inflammatory drugs, in place of surgical therapy as the population of old aged women increases. Furthermore, education of the old aged women who are reluctant to visit Dr`s office how to do self-fitting the pessary will result in time saving and reduction of medical costs.